Showing posts from September 2017

Our latest article has been published in the Chiswick Herald click here or read below:

Make sure depression does not destroy your relationship

In my work with couples it often comes to light, that at some point in the past, one of the couple has struggled with depression. Through therapy couples often come to realise that the way they responded at the time harmed their relationship. In this article I explain what often happens and what to do.

Depression often occurs after something has happened in a person's life that has been difficult to cope with. The struggle can be very tiring, resulting in low confidence and a circle of behaviour that only serves to lead to more unhappiness.

It can have a terrible impact on how someone experiences their life on a day to day basis, symptoms often include a felt sense of low desire to undertake daily activities including work, socialising, exercise etc. It can have a debilitating effect and often be a very confusing experience for the sufferer and their friends and relatives. It can also have a significant impact upon partners and can often lead to the breakdown of relationships.

So what goes wrong? In our relationships we generally expect that partners support each other during difficult times and illness. So far so good! However the difficulty tends to come from failing to support partners in a way that recognises the needs of a healthy relationship.

All too often, the person struggling will most likely be experienced by their partner as withdrawing and this creates a dilemma. On the one hand the partner will be upset to see the person they care about struggling and want to help them, whilst at the same time they are also likely to be struggling themselves with negative feelings about how the relationship with their partner has changed.

To be upset ourselves when our partners are struggling can be difficult as judging thoughts can come to mind like indulgent, selfish, uncaring. We prefer to think that when things go wrong for someone we care about we will drop everything and put the other person first and that they will do the same for us. Whilst this expresses just how important our partners are for us it introduces a mindset that leads to thinking about “them and me” and not about “us”. So at a time when we both most need our relationship to be working well we tend to put it on hold, relegate it, not give it priority.

Quite simply if you are affected by the fact your partner is struggling then you need to look at it as information telling you that your relationship is struggling. If someone is unhappy in a relationship then it is an unhappy relationship and no matter how tempting it is to try and hide this fact from a partner who is struggling, ultimately that partner will not thank you for this further down the line.

So what is it that happens that causes the relationship harm? Usually the partner not struggling puts their needs to one side, they might miss their “old partner”, but they give them space, or their sex life but don’t want to impose, or being able to talk about their own problems. Unfortunately the denial of needs tends to have a habit of impacting upon us in ways we do not expect.

Of course the struggling partner will be finding it hard to carry on as though nothing is happening but if that partner also loses the benefit to their sense of self that comes from being able to make their partner happy, then thats just another thing to add to their probably ever increasing list of failures. They might not even realise this so it is up to the supporting partner to remind them!

Unfortunately patterns get put in place whereby the supporting partner also withdraws and changes their behaviour with the result the way the relationship works is changed to such an extent that a time comes when neither recognise it any more. The relationship can be experienced as lifeless, dead, lonely.

Couples can often avoid this for years, particularly if they have children, busy jobs, other interests etc but ultimately they become to realise that their relationship is no longer there for them.

Main points -

Think about your relationship - it is not helpful to think just about your partner and yourself separately.

Take a step back and think together about what you can do so that you can both feel as though you remain committed to each other

Even if your relationship is in a good place at the moment talk about this now - if trouble comes along you will have an agreed strategy in place and this will make it much easier to have the conversations that will help.

If you or your partner is depressed share this article with them and think about seeking couples / relationship / marriage counselling.

Increasingly over recent years I have worked with patients where either they or their family members have Autism Spectrum Disorder (ASD) or other commonly associated conditions; some examples include ADHD, epilepsy, dyspraxia, obsessive compulsive disorder, dyslexia, Aspergers Syndrome.

I have also understood that for parents getting children assessed, statemented and into appropriate services the challenge has been getting increasingly difficult. BBC News article What is the provision for children with special needs? 2nd June 2016 states:

“Parents have long complained that they have had to battle to get the right support for children facing challenges with their education. The changes introduced from 2014 were an attempt to improve the system.

But many school leaders say they are struggling to offer adequate support for SEND pupils. A survey by The Key found 82% of mainstream schools in England said they did not have sufficient funding and budget to provide for these pupils”.

And a review of annual statistics from the Department of Education that present figures on the numbers of children with assessed Special Education Needs or SEN shows the percentage with an “Autism Spectrum Disorder” as having risen from 20% in 2010 to 26.9% in 2017. And the statistics coming out of the USA are even more alarming. According to the article “Autism cases on the rise; reason for increase a mystery” published on WebMD states that in the 1970’s about one out of every 2000 children had autism but now it is estimated that one in every 150 children at the age of 8 has ASD.

It appears that scientists are not entirely certain why diagnosis is on the increase. Is it because we are getting better at spotting the symptoms? Is it because the demands of our education and work environments has been changing in such a way that people with ASD are more easily recognised? Is it that more people are being born with ASD? But at the moment the exact cause of ASD is unknown, current thinking is that it may occur as a result of genetic predisposition, environmental or unknown factors. In essence no one knows at the moment.

However from my experience what is most clear is that people with ASD and its associated conditions, suffer in ways rarely understood by those that they come into contact with. At home, work and school they are punished, victimised, bullied and discriminated against and often do not get either the understanding or support that might enable them to live more fulfilling lives.

People may have ASD and associated conditions if you observe something that you think is different in the way language is used, how they respond to other people, how they interact, whether they avoid eye contact and / or they have a number of specific behaviours. For example, developing a highly specific interest in a particular subject of activity.

And in addition the difficulties people can have maybe compounded by depression and anxiety that comes about as a result of their painful and isolating struggle to live as they see others doing, to succeed as others do and to have meaningful relationships.

In therapy our work with people who have ASD and associated conditions has the same basic underlying assumption - as we get to know and understand ourselves better we are able to make better choices, be more skilful in our actions - in short know our strengths and weaknesses and increase our understanding of opportunities and threats specific to us as individuals.

As with all my patients, when working with people who have ASD the most important thing for me to do is to discard all my expectations of how I should experience this person. It is so tempting to come up with a list of things that someone else might do differently or better to improve their situation however my patients rarely make progress by being told what to do. I might make suggestions and offer guidnace however progress tends to come from them being able to explore how they experience life, what they see, hear, feel and think. Ultimately for them to come up with ways to improve and address the areas of life that they are finding most difficult.

If you or a family member have been affected by the issues raised in this article there are many excellent information sources available. In particular I use www.NHS.uk and autism.org.uk.